Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression

Abstract

In terms of the methods used to assess for depression, results were varied. This was due to the heterogeneous nature of the individual study designs. The Aberrant Behaviour Checklist consistently showed promise, in particular when combined with other instruments or clinical examination. Qualitative analysis of the selected studies has shown a wide variation in the quality of primary research in this field, with more required to make firm conclusions regarding the diagnosis, frequency and presentation of depression in severe and profound intellectual disability.

Medical Care of Adults With Down Syndrome

“…No studies directly compared symptoms in adults with Down syndrome with the general population. However, 1 systematic review 15 included 3 cross-sectional studies that described symptoms of unipolar depression. Individuals with Down syndrome who met criteria for major depressive episodes had common symptoms (anhedonia, depressed mood, and disturbed sleep) but also hallucinations, and a subset presented with a "deficit" syndrome (apathy, abulia, anhedonia, and mutism) without obvious mood changes or psychosis.…”

Factors associated with depression and anxiety in children with intellectual disabilities

“…Given the concerning prevalence and risk of depressive and anxiety disorders in this population, findings highlight the importance of screening for associative factors in addition to mental health symptoms. That said, there is a critical need to develop effective methods for conducting mental health screening in the population with ID (Mileviciute and Hartley ; Walton and Kerr ). Further, increasing clinician awareness and improving care coordination with mental health services for this population is required.…”

Underdiagnosis of psychiatric disorders in people with intellectual disabilities: Differences between psychiatric disorders and challenging behaviour

“…Moreover, the high prevalence of mental disorders in the subgroup with severe/profound ID could reflect the epistemic difficulties in diagnosing mental disorders among people with severe ID (Borthwick-Duffy, 1994; Rush and Frances, 2000). The limitations in communicating thoughts and feelings among people with severe/profound ID (Matson et al, 1999) and the quite different clinical features of mental disorders in the population with ID (Walton and Kerr, 2016) constrain the epistemic way of measuring behaviour features. This could lead to diagnostic overshadowing as a propensity to overlook real psychopathological phenomena among people with ID, causing a biased assessment of mental comorbidity (Jopp and Keys, 2001) and diagnostic inaccuracy (Smiley and Cooper, 2003).…”